Background, Differences, Challenges, and Barriers
Evidence-based practices (EBP) are the essential methods, which are frequently used. Thyer and McNeece (2014) define them as “treatment based on the best available science,” and it clearly outlines the current attitude toward their implementation (p. 8). The evidence-based practitioner shall consult the empirical literature for the most accurate choosing the appropriate interventions (SW Classes, 2016a). Moreover, the worker relies on the efficacy data and utilized hypothesis-testing, a systematic approach that sets clear goals, develops an individualized treatment plan, and assists in progress monitoring (Thyer & McNeece, 2014); (SW Classes, 2016b). EBP is based on different research methods: systematic reviews, randomized controlled trials (RCT), quasi-experimental studies, case-control and cohort studies, pre-experimental group studies, surveys, and qualitative studies (Thyer & McNeece, 2014, p. 10). In addition, distinct practices have their areas of focus, contexts, challenges, and implementation barriers. Instances of EBP are clinical, macro, community, administrative, and policy (Thyer & McNeece, 2014). The difficulty of their implementation depends on the mentioned methods.
For instance, RCT may not contain enough information about the potential for bias, which ethnic group the participants belong to, and the legitimate random conduct. There is a necessity to ensure the client does not know that they receive less credible intervention than regular ones, as the placebo is used for control (Thyer & McNeece, 2014). Therefore, it might be challenging to implement such a practice in social work treatment. Pre-experimental research is even less credible and complicated for a practitioner to utilize because of the absence of control groups and evaluating only the client’s well-being after receiving treatment (Thyer & McNeece, 2014); (SW Classes, 2016a). Moreover, all the retrospectively designed studies’ results can be questioned, as not appropriately proven ones, which also make such EBP more complicated to utilize than outcome studies.
The Role of Culture In Evidence-Based Practice Implementation
It is vital to consider the role of culture in EBP, especially for persons who have severe and persistent mental illnesses, as it might influence the treatment outcomes. Cultural competence that enables one to take the role of culture into account and act appropriately is vital for a practitioner. Gonzalez (n.d.) defines this term as “the ability to engage in action or create conditions that maximize the optimal development of the client and client systems” (p. 71). EBP in mental health service shall be based on considering the cultural factors to ensure competent clinical care for patients with mentioned above illnesses.
From a historical perspective, the specificities and features of the client’s ethnicity can impact the treatment positively if shared values, common rituals, and other particular characteristics are considered to make the process of care more convenient (Gonzalez, n.d.). In current day perspectives, it might be vital for competent clinical care with the use of EBP to provide mental health treatment concerning socio-cultural-economic forces, such as race, gender, and class (Gonzalez, n.d.). Therefore, there is a necessity to consider the impact of culture on the treatment of persons with mental illnesses to ensure appropriate and competent, individualistic clinical care.
Ethical Implications and Circumstances Under Which Practices Shall not be Used
Consideration of ethical concerns and particular circumstances that limit the use of EBP is due to ensure the safety of their utilization. For instance, some types of knowledge are not included in such practices, according to Allmark (2015), “experience and intuition can point in directions counter to those suggested by EBP” (p. 2). It also implies that sometimes it is better to leave a patient on an old treatment instead of utilizing the new one. The other concern is that EBP runs counter to patient-centered care, which might lead to the situation when patients or practitioners lose choice, and in similar cases, such practices shall not be used. Moreover, EBP might be neglected in case trials produce unethical results, as Allmark (2015) claims that “Testable by RCT” is not the same as “most effective” (p. 3). Therefore, there is a necessity for ethical consideration, and in some situations, EBP shall not be implemented.
References
Allmark, Peter (2015). Ethics and evidence-based practice. In: M. Lipscomb (Ed.), Exploring evidence-based practice: debates and challenges in nursing. Routledge key themes in health and society. (pp. 180-194). Routledge.
Gonzalez, B. J. (n.d.). Evidence-Based Practice With Ethnically Diverse Clients. Web.
SW Classes. (2016a). Overview of Evidence-Based Practice. YouTube. Web.
SW Classes. (2016b). Overview of Evidence Based Practice Part 2. YouTube. Web.
Thyer, B. A., & McNeece, A. C. (2004). Evidence-based practice and social work. Journal of Evidence-Based Social Work, 1(1), 7–25. Web.